Housing Trajectories, Risk Factors, and Resources among Individuals Who Are Homeless or Precariously Housed

• Author: Rosane Nisenbaum,Anita Palepu,Stephen W. Hwang,Ri Wang,Ayda Agha,James Lachaud,Cilia Mejia-Lancheros,Tim Aubry
• Date: 01 January 2021
• DOI: 10.1177/0002716220987203
• Published date: 01 January 2021
• Subject Matter: Trajectories and Transitions

102 ANNALS, AAPSS, 693, January 2021

DOI: 10.1177/0002716220987203

Housing

Trajectories,

Risk Factors,

and Resources

among

Individuals

Who Are

Homeless or

Precariously

Housed

By

TIM AUBRY,

AYDA AGHA,

CILIA MEJIA-LANCHEROS,

JAMES LACHAUD,

RI WANG,

ROSANE NISENBAUM,

ANITA PALEPU,

and

STEPHEN W. HWANG

987203ANN THE ANNALS OF THE AMERICAN ACADEMYHOUSING TRAJECTORIES, RISK FACTORS, AND RESOURCES

research-article2021

This study identifies time-patterned trajectories of

housing stability among homeless and vulnerably

housed individuals who participated in a multisite four-

year longitudinal study in Canada. Findings show four

distinct trajectories for the homeless and vulnerably

housed: high levels of sustained housing stability,

improving levels over time leading to high levels of

housing stability, decreasing levels of housing stability

over time, and low levels of housing stability over time.

The presence of resources rather than risk factors dif-

ferentiated the trajectories of participants who achieved

housing stability from those who had low levels of hous-

ing stability. Participants who had better housing stabil-

ity were more likely to live in subsidized housing.

Findings highlight the need for programs and policies

directed at addressing the housing affordability prob-

lem through income support strategies and the creation

of affordable housing.

Keywords: housing stability; homelessness; trajectories;

risk factors; resources

Homelessness is a significant and visible

social problem in Western industrial coun-

tries (Abbé Pierre Foundation & FEANSTA

2018; The Council of Economic Advisers 2019;

Employment and Social Development Canada

2019). Over the past three decades, the homeless

population has become increasingly heterogene-

ous and includes youth, single adults, and fami-

lies with young children. Moreover, a multitude

of economic, social, health, and personal factors

have contributed to people becoming homeless

and impeded their ability to becoming housed

again and successfully exit homelessness (Gaetz

2010; Thompson etal. 2010; Tsai and Rosenheck

2015). As a result of this heterogeneity, research

Tim Aubry is a full professor in the School of Psychology

and a senior researcher at the Centre for Research on

Educational and Community Services at the University

of Ottawa.

Correspondence: taubry@uottawa.ca

HOUSING TRAJECTORIES, RISK FACTORS, AND RESOURCES 103

identifying subgroups of individuals and families who are homeless has played a

major role in guiding policies intended to address homelessness in the United

States, Canada, and Europe (Aubry etal. 2013; Benjaminsen and Andrade 2015;

Culhane etal. 2007; Daly, Craig, and O’Sullivan 2018; Kuhn and Culhane 1998;

Rabinovich, Pauly, and Zhao 2016).

Kuhn and Culhane (1998) conducted a seminal study using cluster analysis to

identify subgroups of single adults based on length of homelessness and number

of episodes of homelessness over several years in New York City and Philadelphia.

They found three distinct groups that were termed “transitional,” “episodic,” and

“chronic.” The majority of individuals were in the transitional group and were

people who stayed in shelters for short periods of time and most often had one

stay. The episodic group cycled in and out of shelters while staying for relatively

short periods. Finally, the chronic group had the longest shelter stays. Kuhn and

Culhane also found episodic and chronic shelter users more likely to have

Ayda Agha is a community health researcher working at the Centre for Research on

Educational and Community Services at the University of Ottawa. She is currently a doctoral

student in the School of Psychology at the University of Ottawa.

Cilia Mejia-Lancheros is a public health researcher and social epidemiologist working as a

postdoctoral research fellow at MAP Centre for Urban Health Solutions, St. Michael’s Hospital

in Toronto.

James Lachaud is a demographer with research interests in population and public health. He

is currently a postdoctoral research fellow at MAP Centre for Urban Health Solutions, St.

Michael’s Hospital in Toronto, and holds a CIHR-IPPH/CMHC fellowship award in research

and knowledge translation on urban housing and health.

Ri Wang is a statistician working at MAP Centre for Urban Health Solutions, St. Michael’s

Hospital in Toronto.

Rosane Nisenbaum is a biostatistician and associate scientist with MAP Centre for Urban

Health Solutions and the Applied Health Research Centre in the Li Ka Shing Knowledge

Institute of St. Michael’s Hospital and an assistant professor in the University of Toronto’s

Division of Biostatistics at the Dalla Lana School of Public Health.

Anita Palepu is a professor of medicine, general internal medicine at the University of British

Columbia (UBC). She is the Eric W. Hamber Chair and head of the Department of Medicine

at UBC and Providence Health Care in Vancouver.

Stephen W. Hwang is a professor of medicine at the University of Toronto and general internist

at St. Michael’s Hospital in Toronto. He is the director of MAP Centre for Urban Health

Solutions and holds the Chair in Homelessness, Housing, and Health at the University of

Toronto and St. Michael’s Hospital.

NOTE: This project was supported by an operating grant (MOP-86765) and an Interdisciplinary

Capacity Enhancement Grant on Homelessness, Housing and Health (HOA-80066) from the

Canadian Institutes of Health Research. The MAP Centre for Research on Urban Solutions at

St. Michael’s Hospital gratefully acknowledges the support of the Ontario Ministry of Health

and Long-Term Care. The authors thank Ying Di for her expert programming and analyses.

We would like to acknowledge the following individuals from our community partner organiza-

tions: Laura Cowan, Liz Evans, Sarah Evans, Stephanie Gee, Clare Haskel, Erika Khandor,

and Wendy Muckle. The authors also thank the shelter, drop-in, and municipal and provincial

staff for their assistance with participant recruitment and follow-up.